Ms. R is a 65-year-old woman who spends most of her day sitting on her porch and

Question

Ms. R is a 65-year-old woman who spends most of her day sitting on her porch and recovering from a recent surgery involving the removal of suspected cancerous lymph glands in the inguinal area. She is now complaining that her shoes are fitting too tightly, and she has developed poorly healing sores on her legs and ankles. A closer examination also shows distention in her varicose veins. Blood tests reveal a low level of proteins in the plasma.

Discussion Questions for Case Study 2b

Based on the patient history and the signs and symptoms, identify the fluid imbalance the patient is experiencing, and state the rationale for your answer. (See Edema.)

Discuss the four general causes of edema and how they apply in the case of this patient. (See Causes of Edema.)

Discuss the swelling, sores, varicose vein distention, and other effects that edema can have on a patient. (See Effects of Edema.)

Explanation / Answer

The patient is suffering from a condition called lymphedema where the patient's lymphatic vessels are affected. Since the patient already removed a cancerous lymph gland, it indicates dysfunctional lymphatic system. The lymph nodes at the feet have become large and are retaining fluid. Also removal of lymph nodes can cause lymphedema.

Common causes of edema are:

Problems with circulatory or lymphatic system that causes fluid build-up. These problems can be genetic.

Damage to lymph system through cancer, infection or injury.

Medical procedure like removal of lymph nodes.

Radiation therapy.

The swelling and sores are primarily caused by fluid buildup inside the vessels. Discoloration of skin might occur. Hair loss, burning sensation are also a few effects. This also leads to faulty valves in the veins that cause varicose veins.

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